Active NPI
William C. Gimness, O.D., P.S.
- Optometrist
- Chewelah, WA
National Provider Identifier
1871650648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD00001225
- Legal business name
- WILLIAM C. GIMNESS, O.D., P.S.
- Practice address
- 306 N. Park St
Chewelah, WA 99109 - Phone
- (509) 935-2020
- Fax
- (509) 935-6795
- NPI assigned
- Jan 2, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. William Charles Gimness, O.D.
- Title
- Director
- Phone
- (509) 935-2020
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD00001225 | WA | Primary |
| Durable Medical Equipment & Medical Supplies | 332B00000X | OD00001225 | WA |
Addresses
Primary practice location
306 N. Park St
Chewelah, WA 99109
Mailing address
PO Box 836
Chewelah, WA 99109-0836
Phone (509) 935-2020
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2035269 | Medicaid | WA | |
| DB5537 | Other | WA | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryLocations
147 N Clark St
Republic, WA 99166
Phone (509) 775-3075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1261008000000",
"number": "1871650648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 836",
"city": "CHEWELAH",
"state": "WA",
"postal_code": "991090836",
"telephone_number": "509-935-2020",
"fax_number": "509-935-6795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 N. PARK ST",
"city": "CHEWELAH",
"state": "WA",
"postal_code": "99109",
"telephone_number": "509-935-2020",
"fax_number": "509-935-6795"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLIAM C. GIMNESS, O.D., P.S.",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-02",
"last_updated": "2009-12-17",
"status": "A",
"authorized_official_last_name": "GIMNESS",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "CHARLES",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "509-935-2020",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": "WA",
"license": "OD00001225",
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "WA",
"license": "OD00001225",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2035269",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DB5537",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chewelah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.